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Spasmodic DysphoniaPhase 1/2NCT05892770

Zinc Supplementation Prior to Botox Injections for Spasmodic Dysphonia

A Phase 1/2 study testing Zinc gluconate supplement and Botulinum toxin type A in people with Spasmodic Dysphonia, run by University of Florida at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record

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Trial summary

One initial study has shown that Botulinum Toxin (BT) in combination with zinc supplementation may increase the duration of effects BT treatment. This initial study was in the context of facial aesthetics. Read more about this study

Who is it for?
Ages 18 to 99 yearsHealthy volunteers can take part
Conditions the study is for
Spasmodic Dysphonia
What is being tested?
Zinc gluconate supplement and Botulinum toxin type A
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
32 participants
Where
1 siteUnited States
Study dates
1 Aug 2023to 1 Mar 2025
Phase
Phase 1/2

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 99 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Adults patients
  • 18 years old and above
  • Current diagnosis of ADductor spasmodic dysphonia
  • Has had Botox injection treatments for SD > 6 months

Who cannot join

  • Pregnant
  • Diagnosis of ABductor spasmodic dysphonia
  • Patients taking > 30 mg zinc supplementation daily prior to study beginning

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Florida- Shands Hospital

    Gainesville, Florida, 32610

Other trials in United States

About this study

Official title: The Effect of Zinc Supplementation Prior to Botulinum Neurotoxin Type A Injection in the Treatment of Spasmodic Dysphonia

One initial study has shown that Botulinum Toxin (BT) in combination with zinc supplementation may increase the duration of effects BT treatment. This initial study was in the context of facial aesthetics. The purpose of the present study is to determine the effect, if any, of oral zinc supplementation prior to BT in the treatment of spasmodic dysphonia. If positive effects will be observed, this would help reduce the burden of disease for these patients.

Read the detailed description

Botulinum toxin (BT) injections are commonly used to treat various cosmetic, muscular, anesthetic, and neurologic pathologies. In 2012, one study suggested that a combination of zinc and phytase supplementation could increase the duration and degree of effects of botulinum neurotoxin type A (BoNTA). However, this study was met with scientific skepticism due to concerns of financial conflicts of interest, unmasking the study too early, and ambiguity of the dosage of zinc used. In 2021, a new study with 25 patients receiving BoNTA injections for the treatment of excessive gingival display (EGD), showed that zinc supplementation prolonged the effect of BoNTA with statistical significance. There has been no further studies or commentary since these latest results were published. The purpose of this study is to test if the effect of zinc supplementation on BoNTA can be replicated and also translated to a different disease process that is also treated with BT-spasmodic dysphonia (SD). If positive effects are discovered, this would strengthen the preliminary results of the 2021 study, encourage future larger studies on the same hypothesis, and, ultimately, could lead to reducing the burden of disease for patients with SD and any other condition that is treated with BT injections.

Being tested
Zinc gluconate supplement, Botulinum toxin type A
Keywords
zinc, botox, botulinum toxin, spasmodic dysphonia
Medical subject headings
Dysphonia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Zinc gluconate supplementDrug

    Also called 50 mg zinc gluconate (Puritan's Pride brand)

    Subjects will take a 50 mg zinc gluconate supplement at breakfast for the five days leading up to their next injection appointment. They will also answer questionnaires and provide audio recordings at various time points of the two injection cycles, which is roughly six months.

  • Botulinum toxin type ADrug

    Also called Botox Type A

    This is the current standard of care for treatment of spasmodic dysphonia. Botox injection goes into the vocal cord muscle, and will be occur in both the control and experimental arms of the study.

Study groups in NCT05892770
Study groupRoleWhat they receive
Botulinum toxin A injectionActive comparatorBotulinum toxin A injection into vocal cords for treatment of spasmodic dysphonia. This is the current standard of care for treatment of this disease process. This will be the control of the study.
Receives: Drug: Botulinum toxin type A
Botulinum toxin A injection +zinc supplementation"ExperimentalBotulinum toxin A injection into vocal cords for treatment of spasmodic dysphonia, with subject taking zinc supplementation daily for the 5 days preceding the botox injection. This will be the experimental arm of the study.
Receives: Drug: Zinc gluconate supplement; Drug: Botulinum toxin type A

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change of Voice-Related Quality of Life (V-RQOL) Survey Scores During a Laryngeal Botox Injection Cycle.

    10 question, validated survey to assess quality of voice of patients with spasmodic dysphonia. The overall V-RQOL score ranges from 10 to 15 (excellent), 16 to 20 (very good), 21 to 25 (good), 26-30 (fair) and scores more than 30 and up to 50 is poor.

    Measured: The patient will submit survey on post-injection day 2, 7, 14, 42, 70 and 98 (if next injection has not been performed).

  2. Change in Audiometric Recording Data of Subject's Speech During a Laryngeal Botox Injection Cycle.

    At various points in the study, each subject will be recorded saying the same scripted passage. After all subjects have completed both cycles, all of the accrued audio recordings will be analyzed using a computer algorithm developed by one of our authors that assesses the quality of speech, with the data time points being averaged. The proposed algorithm was not successfully developed. One of the major concerns during the development process was which Natural Language Processing metrics should be utilized to best measure Spasmodic Dysphonia speech changes. No analysis conducted.

    Measured: The patient record their voice on post-injection day 2, 7, 14, 42, 70, and 98. At their next botox injection, a second cycle will immediately begin for an additional 3 months with audio data obtained on post injection day 2, 7, 14, 42, 70, and 98

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Jun 2023
  2. Study start1 Aug 2023
  3. Primary completion1 Aug 2024
  4. Study completion1 Mar 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Crossover
Model description
Patient will be followed for one botox cycle as is current standard of care, and another botox cycle with the proposed intervention of zinc supplementation. Each patient will serve as their own control group.
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
32 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05892770
Sponsor's protocol ID
IRB202202375
Other IDs
OCR43808
Status last verified
Nov 2025
First submitted
26 Apr 2023
Last updated
27 Jul 2026
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

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